British personal trainer needs £250,000 to get home from Thailand after falling from third-storey balcony and suffering horrific injuries while on holiday

[Artisi]

5 minutes ago, Pedrogaz said:

I wonder why so many people fall from balconies in Thailand?

Too many - but always their fault or some other party's fault (supposedly)

[itsari]

8 minutes ago, Pedrogaz said:

I wonder why so many people fall from balconies in Thailand?

The gravity of the situation is gravity 

[Sheryl]

5 hours ago, thaibeachlovers said:

As we don't have all the facts, we can't really comment as to why the insurance company are reluctant to pay up, but if they did the right thing and got proper insurance, it's an unfortunate situation. 

I can't see them getting 250,000 quid from strangers so I have no idea as to what can happen now.

There is no way he can fly home without an air ambulance and obviously they can't pay to stay.

However, there has to be an answer- perhaps the UK government can fly him home on a military flight.

 

Might be an issue of his having been intoxicated at the time - or insurer may be trying to ascertain if this was the case.  Or ditto that it was not a suicide attempt. An accident due to intoxication (alcohol or drugs), and suicide attempts,  would be excluded from most policies.

 

He does not have to travel by air ambulance, can go on a commercial flight but would have to buy out a full row in business class to accommodate stretcher and have a medical attendant (nurse). Often done and hospitals can help coordinate it, or there are companies that do this. Still not cheap but nowhere near the price mentioned here. From what I recall something along the lines of US$40,000 all in.

 

They likely also need funds to pay accumulated hospital bill, though, and hospital won't let him leave until it is paid.

 

Still not likely to reach much more than  100,000 pounds though.

[Ginner]

6 hours ago, Pique Dard said:

...it is not good to blame someone in his position, but how can he travel so faraway from his country without insurance?

Doesn't say how he came to fall off the balcony, was the balcony not at a safe height? Sue the hotel. Doesn't say why his travel insurance are refusing to pay, was he not covered for such an amount?.

[Derek B]

Surely cheaper to have the required surgery in Thailand.

[Gottfrid]

5 hours ago, ukrules said:

Why do you think he didn't have insurance?

 

They don't want to help, that's the message I read. I wonder who his insurer is and why they're dragging their heels on paying?

Maybe because they do not believe people just falls from balconies, without alcohol or any drugs included. The question is what stands in the insurance about stuff like that.

[NanLaew]

4 hours ago, itsari said:

The insurer would have to prove that alcohol was the root cause of the accident .  

Just the fact the insured has been drinking is not enough for the insurer to deny the claim .

Maybe the insurance company is waiting for proof that alcohol was NOT involved before handing out the cash? It's possible there's a police report on the incident or they are seeking eyewitness testimony? It's also common for medical evacuation to be an add-on or only available under more expensive 'Premium' coverage. Either way, it's still their money.

[mikeymike100]

10 minutes ago, Derek B said:

Surely cheaper to have the required surgery in Thailand.

At the Bangkok Hospital in Phuket, maybe a 'push'?

Problem here is he is accumulating daily expenses ta the Hospital whilst the Insurance Company deliberates. Why is the Insurance Company taking so long, without knowing more facts its difficult to make any kind of educated guess?

[norfolkandchance]

This off the fund raising site.

[jimn]

5 hours ago, sletraveler said:

Isn’t that standard for insurance companies?   They look for any means possible to deny payment since it affects their bottom line. 

The chances are that the insurance only covers treatment at a local government hospital and not an expensive private hospital like the Bangkok Phuket hospital. This is common with travel insurance.

[robblok]

5 hours ago, scubascuba3 said:

Shame article doesn't say why claim denied, I'll guess, alcohol. There will be an exclusion in policy, it's standard

This is a donation / sympathy article. Not an article to get the facts straight. They havent interviewed the insurer. Not sure if they would even comment on a case like this (privacy and all).

 

This is really one sided so they don't want to give the reasons as it might reflect bad on them and not fit the sob story. 

 

Because if they lie the insurer might sue them or bring out the real story. So better to keep quiet.

 

In cases like this there is quite often more to it people always like to pain themselves as 100% in the right and the big bad insurer is wrong.

 

I too would like to know the reasons. 

[PingRoundTheWorld]

Medical evacuation does not cost a quarter million. Something (many things) is off here.

[Neeranam]

7 hours ago, Pique Dard said:

...it is not good to blame someone in his position, but how can he travel so faraway from his country without insurance?

Ever heard of hitting someone while they are down? I lived here for 20 years with no insurance. 

[Sheryl]

21 minutes ago, Gottfrid said:

Maybe because they do not believe people just falls from balconies, without alcohol or any drugs included. The question is what stands in the insurance about stuff like that.

As I previously mentioned most policies would exclude accident due to intoxication, ditto suicide attempts.

 

Certainly a "fall from balcony" would raise questions in an insurer's mind. Though the onus of proving drugs or alcohol were involved, or that it was self-inflicted,  would fall on the insurer. If no evidence of same in his medical record then the family should appeal to the relevant Ombudsman. 

[Artisi]

2 minutes ago, PingRoundTheWorld said:

Medical evacuation does not cost a quarter million. Something (many things) is off here.

no, but the fees charged by big hospitals especially for farangs do.

[DFPhuket]

Here is what my AIG Travel Guard policy says about exclusions. I assume other policies have similar exclusions.

 

The insurance under this agreement does not cover the following expenses: 

 

16. Injury arising from the action of the insured while the insured is under the influence of alcohol, addictive substance, or narcotics to the extent of being unable to control one's mind.

 

17. The term "under the influence of alcohol" in case of having a blood test refers to an alcohol level of 150 mg percent and over. (Note: that is a 0.15% blood alcohol level, which is 3 times over the driving limit)
 

[Sheryl]

6 minutes ago, jimn said:

The chances are that the insurance only covers treatment at a local government hospital and not an expensive private hospital like the Bangkok Phuket hospital. This is common with travel insurance.

I have never seen or heard of a travel policy that specifies only treatment at a government hospital. In fact, most government hospitals are unable to supply the documentation required by insurance companies (and this, more than lack of insurance, is why government hospitals in tourist areas often end up unreimbursed. It takes more than an invoice to get payment from an insurance company).

 

The policy will of course have had a financial limit. What, we don't know. But as the article did not mention that as a factor, and seemed to indicate no insurance payment of any amount to date,  I think it morel likely an issue of the circumstances of the accident.

[PingRoundTheWorld]

1 minute ago, Artisi said:

no, but the fees charged by big hospitals especially for farangs do.

I have a friend who was hospitalized at Bangkok hospital Phuket last year. The whole thing, including flying him out to Bangkok, cost about $20k. Sure it's expensive, but it's not 250k.

[NoDisplayName]

Seems to be common enough problem to show up on interwebs insurance blogs.

 

 

Quote

 

9. Dangerous or illegal behaviour

For many people, a holiday is a chance to relax and have some fun – but it’s important not to get carried away with this. Putting yourself in unnecessary danger (by trying to climb from one hotel balcony to another, for example), drinking too much alcohol and taking illegal drugs are all ways to invalidate your travel insurance.

If you’ve injured or made yourself ill while drunk and end up in hospital, you may be left out of pocket if you can’t claim on your travel insurance. 

https://www.admiral.com/magazine/guides/travel/10-ways-to-invalidate-your-travel-insurance

 

 

[Neeranam]

4 minutes ago, Sheryl said:

As I previously mentioned most policies would exclude accident due to intoxication, ditto suicide attempts.

 

Certainly a "fall from balcony" would raise questions in an insurer's mind. Though the onus of proving drugs or alcohol were involved, or that it was self-inflicted,  would fall on the insurer. If no evidence of same in his medical record then the family should appeal to the relevant Ombudsman. 

Isn't the Ombudsman only for affairs related to government?

[Sheryl]

2 minutes ago, Neeranam said:

Isn't the Ombudsman only for affairs related to government?

The UK Financial Ombudsman office helps with a number of consumer issues including  related to private insurance

 

https://www.financial-ombudsman.org.uk/consumers/complaints-can-help/insurance

 

Many people have used it with good effect

 

However if this accident was due ot intoxication, and there is evidence of it, they are out of luck.

[Maestro]

Removed some off-topic posts and the replies to them.

[Mike k]

6 hours ago, ezzra said:

What is it with travel insurance companies who are quick to tame your money but very slow and playing hard to get when the chips are down and they have to pay? I can't see that this kind of money can be raised quick enough for the young block to be sent home for the urgent treatment he needs.

Same as most insurance companies they want your money but don't want to pay out 

[NoDisplayName]

Reading the linked article in the Daily Mail, there was no claim that the insurance company is refusing to pay medical expenses.

 

There was the statement that "the couple's medical bills have piled up," but no indication that any claims have been denied.

 

It seems the full amount embegged is solely for the return flight.  From the article:

 

Quote

Brit needs £250,000 to get home

trainer needs £250,000 to get home

return to the UK could cost £170,000-£250,000 without insurance help

desperately needs £250,000 to get home for urgent surgery.

...flown back to the UK for the procedure, but this could cost between £170,000-£250,000 'without any help from the insurance'.

...advised that we fly home in an air ambulance for his second operation, however, we have been given quotes from £170,000-£250,000 without any help from the insurance. 

I would take from this that repatriation costs were not included in the insurance policy.

 

It appears that they want to purchase a private air ambulance for the flight home.

[phetpeter]

I understand that people on Holiday, can have accidents, or become ill. But why is it those looking to get people to send money, beause of high costs, and insurance company problem. seem to be the ones who automatically go to the private/international hospitals. I doubt they would have such huge costs. if they were to transfer themselves or go directly to the government hospitals. The large government hospitals have everything for all cases. I have had in 15 years two heart attacks and have been treated in the government hospitals including being treated the last occassion in the local hospital, transported by government ambulance 200 kilometres to the larger hospital with heart department, treated and transported back, plus recovery in a private room to recover. at a faction of the 10K plus a night at private hospital. Plus knowing the costs would go back into the government sector to keep improving the great services they give. I would also think the insurance companies would also be happier to pay the bills due to the lower costs. May I suggest contacting the insurance company to pay the bill, and transfer him to a government hospital to recover.

[actonion]

4 hours ago, bradiston said:

I'm always curious to know how you fall out of a 3rd floor balcony, or any other balcony. I guess the insurance company is asking the same question. If the balustrades are dangerously low, don't go out there.

Having lived in many Condo blocks around Pattaya, yes the balcony railings are dangerously low, below waist height on a 6 foot male, but  with no health and  safety, or building regulations, that are any good  in Thailand, these incidents will continue

[crazykopite]

Why are they struggling to get the insurance company to cover the cost they have a contract with the insurers 

Edited February 28, 2023 by crazykopite

[bradiston]

2 hours ago, Artisi said:

Because the height of Thai balcony rail / panel are very low compared to western standards, I've  some less than 1m, this is about or even  below the tip-over point for an average farangs height. 

As a previous poster pointed out - stay well away from Thai balcony rails,

for 2 reasons 

1. Low 

2 Insecurely fixed into the floor /wall. 

Yes, you're right. And worse still, leaning against one, for instance with a drink in your hand chatting to a friend and simply tipping over backwards when it gives way. Nightmare. Maybe that's what happened here.

 

I don't know where this happened but couldn't a local paper, Pattaya/Phuket News, or some such, get to interview him or his girlfriend and find out?

[retsdon]

Years ago I worked in a law firm that had a big trade union as one of our clients. Nearly all the work involved negotiating with insurance companies who were basically trying to wriggle out of their liability to pay accident and personal injury insurance on behalf of their insuree (the workers' employer). These insurance companies would deny all liability as a matter of course, and every time we'd have to go through this tedious rigamrole of multiple meetings in which they'd try to gyppo some poor sod out of compensation for having lost his leg or whatever, before eventually with a County Court action pending they'd roll over and pay. They had no compassion whatsoever and if the union hadn't been there to back their members with the money for legal bills, these injured people would have got nothing.

Never been a fan of insurance companies since....

Edited February 28, 2023 by retsdon

[retsdon]

20 minutes ago, crazykopite said:

Why are they struggling to get the insurance company to cover the cost they have a contract with the insurers 

Having a contract and having the means to enforce it are two different things.